OHIP billing code for other immunizations

OHIP immunization billing codes: G538A for a vaccine with no code of its own, plus G700A when the shot is the only reason for the visit.

Code	What it is	Fee
G538A	Other Immunizing Agents	$8.80
G700A	Basic fee per visit Premium if sole reason for procedure/immunization	$8.80

G538A: Other Immunizing Agents

Immunization with a vaccine that has no specific OHIP code of its own. Add G700 when the shot is the only reason for the visit.

Marked (+): when the immunization is the sole reason for the visit, add G700, once per patient per day however many vaccines or (+) procedures are given (J3, J54).
G700 is not payable in hospital, and is paid at 15% of its fee for patients enrolled to a capitation-based group (J3).
May be delegated to trained office staff, even when you aren't on site, for your own patient; the chart must name who gave it (GP62–GP63).
Payable on the same day as a counselling service by the same physician (GP58).
The Schedule notes an immunization may be uninsured in some circumstances and refers to section 24 of Regulation 552 under the Health Insurance Act (J54, AA1).

VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).
EH2: The health card version code on the claim doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit.
V23: OHIP questioned the number of services on the line; check the count and that the code carries the A suffix for your own service.
VH9: The health number on the claim isn't registered with the Ministry; check it against the patient's card and resubmit.
EH4: OHIP's record shows the patient's coverage ended before the service date; confirm the health number and service date, then the patient's coverage.

Premium added once per visit when a procedure marked (+), such as a vaccine or venipuncture, is the only reason for the visit.

Payable only with a procedure marked (+), and only when the procedure(s) are the sole reason for the visit (J3).
Once per patient per day, regardless of the number of procedures (J3, J54).
Not payable for a service provided in a hospital (J3).
Not payable when the (+) service itself is not eligible for payment (J3).
Not payable when a consultation or assessment is payable to the same physician for the same patient that day and the physician has a financial interest in the facility (J3).

EH2: The health card version code on the claim doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit.
VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).
EH4: OHIP's record shows the patient's coverage ended before the service date; confirm the health number and service date, then the patient's coverage.
VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.

OHIP immunization billing codes: G538A for a vaccine with no code of its own, plus G700A when the shot is the only reason for the visit.

Updated October 26, 2026.